Thursday, February 17, 2011

EDC Announces “HOLDING INSURANCE COMPANIES ACCOUNTABLE”

The Eating Disorders Coalition (EDC) is disturbed by the brazen and wide-sweeping trend among health insurance companies to limit the scope of treatment benefits for eating disorders.

February 17, 2011 marks the 11-year anniversary of the death of Anna Westin, a young woman who died from her eating disorder after being denied adequate treatment by her insurance company. As a result of Anna’s death, her former insurance company recognized the need for adequate coverage of necessary treatment for eating disorders and now covers that.

Sadly, other insurance companies do not. Across the country, insurance companies are eliminating, denying, and severely limiting coverage for eating disorder treatment.

Westin’s mother and EDC Board Member, Kitty Westin, says, “These insurance denials are all too reminiscent. Isn’t 11 years enough time to do the right thing? How many more people must die before insurance companies get the message that adequate coverage isn’t a luxury, but a life-saver?”

For example, in January of 2011, Federal Blue Cross Blue Shield categorically eliminated residential treatment as a covered mental health benefit from the Federal Employee Health Benefits Program. They made this decision despite solid clinical evidence proving that residential treatment is a critical stage of comprehensive and effective treatment for those suffering from eating disorders.

Residential eating disorders treatment is optimal for recovery for some people suffering from eating disorders because it provides a home-like setting, simulating day-to-day living where patients can practice coping skills learned in therapy sessions. Onsite and ongoing medical monitoring assists patients to re-establish regular eating and medical stability. Residential treatment also allows for essential reintegration back into the community, while providing structure and support.

Specialized treatment for eating disorders is cost effective and reduces mortality. Residential treatment is a good investment, as it reduces the risk of relapse when the appropriate amount of treatment is provided. Inadequate treatment virtually guarantees relapse and the need for additional treatment. The EDC argues that treatment should be determined by severity and type of illness, rather than what is arbitrarily allowed by an individual’s insurance company.

Other insurance companies are using a twisted interpretation of the mental health parity law passed in 2008 as justification for denying coverage of residential treatment. According to their interpretation of the parity law, since there is rarely any residential benefit under the medical/surgical portion of the insurance plan, they state there is no need to provide residential coverage for mental illnesses.

The EDC finds it insulting that these insurance companies are responding to federal legislation that was designed to provide consumers with more access to care - by providing less! That was not the intention of Congress when it passed the federal parity law. Indeed, according to the Final Interim Regulations, using the parity law to provide less favorable benefits for mental illness undercuts the very protections that the statute was intended to provide. Not complying with the parity regulations is a calculated effort to avoid costs at the expense of people's health and lives.

After a decade of championing legislative efforts to promote optimal access to treatment, the EDC is addressing this trend head on. We have created the Campaign for "Holding Insurance Companies Accountable" where we are working with families, specialized attorneys, and experts in the field to put an end to such discriminatory and deadly practices.

What can you do? The EDC is currently looking for people who have been denied insurance coverage for residential treatment in our efforts to hold insurance companies accountable.

Email us at EDCHoldsInsuranceAccountable@yahoo.com with your story of denial of residential care in your state. We will collect your stories to leverage change.

Eleven years is far too long to wait. Join us and STAND UP now to the sweeping denial of residential treatment coverage for eating disorders.

2 comments:

This is a wonderful initiative! Sadly, I'm sure there will be no shortage of individuals with stories to share. You have the full support of The Joy Project. We'll be sharing this information with our members. Keep up the great work!